{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T12:22:45Z","timestamp":1787401365200,"version":"build-2736575974"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Severe dilutional hyponatraemia is a recognised complication of transurethral resection of the prostate (TURP syndrome) caused by systemic absorption of hypotonic irrigation fluid, but similar events outside the operative setting are rarely reported. We describe a 77-year-old White male with radiation cystitis who underwent 12\u00a0days of sterile water bladder washouts alongside continuous 0.9% saline bladder irrigation for persistent haematuria. Serum sodium declined from 132 to 112\u00a0mmol\/L and improved only after bladder washouts and irrigation were discontinued. Cystoscopy confirmed radiation cystitis with mucosal ulceration. The clinical course strongly suggests that systemic absorption of electrolyte-free sterile water caused the profound hypotonic hyponatraemia, whereas concurrent absorption of isotonic saline contributed to extracellular volume expansion. This case highlights that prolonged sterile water bladder washouts may produce a TURP-like syndrome in the absence of surgery. Early recognition, serial electrolyte monitoring and prompt source control are essential to prevent potentially life-threatening complications.<\/jats:p>","DOI":"10.1093\/omcr\/omag150","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:57:43Z","timestamp":1785412663000},"source":"Crossref","is-referenced-by-count":0,"title":["TURP-like syndrome without surgery: severe dilutional hyponatraemia following prolonged sterile water bladder washouts for radiation cystitis: a case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3279-7846","authenticated-orcid":false,"given":"Hafiz Awais","family":"Javed","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, West Suffolk NHS Foundation Trust , Bury St Edmunds, Suffolk , IP33 2QZ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisy","family":"Beard","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, West Suffolk NHS Foundation Trust , Bury St Edmunds, Suffolk , IP33 2QZ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Launchbury","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, West Suffolk NHS Foundation Trust , Bury St Edmunds, Suffolk , IP33 2QZ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehan","family":"Masood","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, West Suffolk NHS Foundation Trust , Bury St Edmunds, Suffolk , IP33 2QZ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna","family":"Zeeshan","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, West Suffolk NHS Foundation Trust , Bury St Edmunds, Suffolk , IP33 2QZ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haris","family":"Marath","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, West Suffolk NHS Foundation Trust , Bury St Edmunds, Suffolk , IP33 2QZ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"2026082207314317600_ref1","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-13-1020","article-title":"Clinical practice guideline on diagnosis and treatment of hyponatraemia","volume":"170","author":"Spasovski","year":"2014","journal-title":"Eur J Endocrinol"},{"key":"2026082207314317600_ref2","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.eururo.2009.06.037","article-title":"Results from an ongoing prospective randomised controlled study comparing bipolar with monopolar transurethral resection of the prostate","volume":"56","author":"Mamoulakis","year":"2009","journal-title":"Eur Urol"},{"key":"2026082207314317600_ref3","doi-asserted-by":"crossref","first-page":"bcr2012006879","DOI":"10.1136\/bcr-2012-006899","article-title":"TURP syndrome and severe hyponatremia under general anaesthesia","volume":"2012","author":"Demirel","year":"2012","journal-title":"BMJ Case Rep"},{"key":"2026082207314317600_ref4","first-page":"97","article-title":"Pathophysiology and management of radiation cystitis","volume":"11","author":"Zwaans","year":"2019","journal-title":"Res Rep Urol"},{"key":"2026082207314317600_ref5","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/1471-2490-14-91","article-title":"Bladder irrigation and urothelium disruption: a reminder apropos of a case of fatal fluid absorption","volume":"14","author":"Di Paolo","year":"2014","journal-title":"BMC Urol"},{"key":"2026082207314317600_ref6","first-page":"e11927","article-title":"First reported case of hyperchloremic non-anion gap metabolic acidosis in a patient undergoing continuous bladder irrigation for hemorrhagic cystitis","volume":"12","author":"Latif","year":"2020","journal-title":"Cureus."},{"key":"2026082207314317600_ref7","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1520\/JFS13331J","article-title":"Sudden death due to intravascular hemolysis after bladder irrigation with distilled water","volume":"37","author":"Bell","year":"1992","journal-title":"J Forensic Sci"}],"container-title":["Oxford Medical Case 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